A FAMILY OF Maladie des Tics

Abstract

The author described a family with tic in three generations, the inheritance being irregular dominant varying in expression.
The proband (III-1 in the pedigree chart) aged 15, boy student of a high school, had since 9 years of age symptoms of particularly limited tic movements like grimace and hand shaking without any psychological motive to speak of, and then, as he grew in age, also began winking, springing, throwing things up or dropping, stretching the left hand forward and twisting its fingers, together with tic of the tongue, M. stapedius, and abdomen. Also echolalia, various uncontrollable movements, fitful mental disorder, self-injury and coprolalia were recognized during his hospitalsation. He received insulin shock, electroshock and psychotherapy without effect. Having extremely pleiotropic symptoms and progressive course with an incurable tendency, this case should be included into the category of “Maladie des Tics” first recorded by Gullies du la Tourette in 1885. The present author believs there must be some essential difference between this form of tic and the functional or psychogenic one, because the former may be due to a rare specific mutant gene, while the latter is much common in the population developing constitutional abnormality.
It is interesting, too, that five persons in this family showed various kinds of mental disorder, which probably had genetic relation to the condition of tic, both concurring in the same line of this family, and resembled one another, all developing into temporary state of confusion by psychogenic or somatogenic motivation.